241 entero 18 jan 2012

Enterobacteriaceae

Vibrionaceae

Helicobacter

Nonfermenters

Anusorn Boonthum

Micro311241

E. coli Shigella Salmonella Vibrio Helicobacter Pseudomonas Burkholderia

Acinetobacter E. coli (ETEC, EIEC, EHEC)

Shigella Salmonella Vibrio

E. coli Shigella Salmonella Vibrio Helicobacter Pseudomonas

Burkholderia Acinetobacter 2

MCQ 10

FAMILY ENTEROBACTERIACEAE

0.5 - 2 m

2 - 4 m

Morphology

3


E. coli

Klebsiella

Enterobacter

Proteus, Morganella

Citrobacter

Serratia

Intestinal flora

Coliform

4


E. coli causing diarrhea

Salmonella

Shigella

Yersinia enterocolitica

5

Enteric pathogens in human

- Salmonella - Enterobacter

- Proteus

- E. coli

peritrichous flagella

6

Cell Wall of Gram-Negative Bacteria

Lipopolysaccharide (LPS)

7

Physiologic Action of LPS from the Gram-Negative Cell Wall

8

Endotoxin

Exogenous pyrogen

IL-1 TNF-a

Endogenous pyrogen

Platelet aggregation

factor Membrane attack complex

Toll-like receptor

Animation

9

Facultative anaerobe

10

Escherichia coli

11

Escherichia coli

MacConkey agar

Ferment lactose

Pink, red colony

12

(Intestinal flora)

(Faecal contamination Index)

Faecal E.coli

Escherichia coli

13

1. Enteropathogenic E. coli (EPEC)

1

14

2. Enterotoxigenic E. coli (ETEC)

(travelers diarrhea)

(watery diarrhea)

15

Shigella

3. Enteroinvasive E. coli (EIEC)

16

4. Enterohemorrhagic E. coli (EHEC)

E. coli O157:H7

V e r o t o x i n

17

4. Enterohemorrhagic E. coli (EHEC) E. coli O157:H7

18

hemolytic uremic syndrome (HUS)

(3-5% HUS)

4. Enterohemorrhagic E. coli (EHEC)

5-8

19

The 2011 E. coli O104:H4 outbreak

(E.coli )

20

Urethra

Vagina Anus

E.coli

Shigella

21

Shigella

(Nonlactose fermenter on MacConkey agar)

MacConkey agar

Nonlactose ferment

Colorless

22

(Classic bacillary dysentery)

Infective dose 200 - 1000 cells 23

peritrichous flagella

Salmonella

25

Salmonella

Nonlactose fermenter

MacConkey agar

SS agar

26

3 1. (Enteric fever)

Salmonella Typhi

Salmonella Paratyphi A, B, C

Systemic disease originating in the GI tract

Salmonella Typhi

BLOOD STREAM

MESENTERIC LYMPH NODES

Typhoid

Infective dose 103 - 105

Invade mucus layer and

attach the

intestinal

epithelium cell

(IEC) by

fimbriae

28

Diarrhea;

hemorrhage;

perforation

Cholecystitis;

carrier state

Fever;

kidney and

other organs

infected

Ingestion of S.Typhi

Inflammation and

ulceration of

Peyers patches Small

intestine Lymphatics

MLN

Thoracic duct

Transient

(primary)

bacteremia Multiplication

in macrophages

in

liver,

spleen, and

bone marrow

Septicemia

Bile

Signs and

symptoms

Gallbladder

Incubation

period

1. Enteric fevers : Typhoid & Paratyphoid

MLN = Mesenteric lymph nodes 29

1. (Enteric fever) macrophage (mesenteric lymph nodes) thoracic duct (Transient, Primary bacteremia) macrophage (Septicemia) 7-20 30

1. (Enteric fever)

31

1. (Enteric fever)

4-6

1 2%

32

Typhoid fever

http://bestpractice.bmj.com/best-

practice/monograph/221/basics/epide

miology.html

2. (Septicemia)

S. Choleraesuis

33

3. Gastroenteritis

Salmonella S. Typhi S. Paratyphi S. Choleraesuis

8-48 2-5

34

Lactose fermenter, mucoid colony

Klebsiella

35

Pathogenicity

Pneumonia

enterotoxin

Urinary tract infection (UTI)

etc

Klebsiella pneumoniae

36

Bubo

1. Yersinia pestis

(Zoonosis)

(Bubo)

37

Sci 4 Oct 2001

Plague ()

38

Differentiation of family Vibrionaceae from

Enterobacteriaceae

Characters Vibrionaceae Enterobacteriaceae

Curved rod +/- -

Oxidase + + + -

Motility + +/-

Flagella locations Polar Peritrichous

39

VIBRIO CHOLERAE

flagella

40

Yellow colony on Thiosulfate Citrate

Bile salt Sucrose agar (TCBS)

41

Fecal-oral route of transmission

Infective dose : 106 - 108

1-4

42

10-20

40

: tetracycline, quinolone Oral Rehydration Solution (ORS)

44

VIBRIO CHOLERAE

Classical

El Tor

O1

Ogawa

Inaba

Hikojima

Hikojima

Inaba

Ogawa

O139

NonO1/non O139

45

99 % of isolates

is V. Cholerae

El Tor Inaba

Cholera 2547

V. Cholerae El Tor Ogawa 982

V. Cholerae El Tor Inaba 11

Cholera 2553

1-100

3 9 993

V. parahaemolyticus

3-8%

TCBS

Gastroenteritis

: 4 - 48 ( 8 - 10) 46

V. vulnificus

2-3% V. parahaemolyticus

47

V. vulnificus

2

4 4 12

48

V. vulnificus

12-72

50

49

CAMPYLOBACTER

Corkscrew-like motion with single

polar flagellum at one or both

Microaerophilic

Growth at 42 oC

50

PATHOGENICITY

C. fetus Septicemia

C. coli Diarrhea

C. jejuni Enteritis

51

Helicobacter pylori

52

PATHOGENICITY

53

http:// nobelprize.org/medicine/laureates/2005/index.html 54

15%

2/3 Pseudomonas aeruginosa

Nonfermenters

Opportunistic pathogens

54

Pseudomonas aeruginosa

Polar flagella (1-2)

Nonsporulation

Noncapsulated

Gram negative bacilli

55

Pyocyanin Pigment

Grape-like odor

Pseudomonas aeruginosa

56

P. aeruginosa

1.

54

Nosocomial infection:

Urinary tract infections (UTI)

P. aeruginosa

1.

54

P. aeruginosa

1.

2.

3. 4.

54

Burkholderia pseudomallei


- Bipolar

staining or

safety pin

- Polar tuft flagella

- Oxidase positive 58

Musty or earthy odor

18 24 h incubation

Smooth colony

> 48 h incubation

Wrinkle colony


59

Geographic distribution of B. pseudomallei

Melioidosis = Severe disease

60

CLINICAL FEATURES

1) Wound infection

2) Pulmonary infection

3) Septicemia

abscesses in internal organs

:- liver abscess

Person-at risk : Farmer, Diabetes mellitus (DM)

61

Acinetobacter

Hospital-acquired infection ventilator-associated pneumonia

Aerobic gram-negative coccobacilli, non-motile

A. baumannii

Acinetobacter

Hospital-acquired infection ventilator-associated pneumonia

antibiotic A. baumannii . gentamicin, amikacin, piperacillin, imipenem, ceftazidime, ciprofloxacin

Aerobic gram-negative coccobacilli, non-motile

A. baumannii

Antibacterial drugs % Susceptibility

Colistin 99

Gentamicin 25

Amikacin 28

Cefoperazone-sulbactam 31

Ceftazidime 23

Cefepime 21

Imipenem 26

Meropenem 27

Ciprofloxacin 23

Percentage of Susceptible A. baumannii

MAHARAJ NAKORN CHIANG MAI HOSPITAL, JAN-DEC 2009

Differentiation of enteric bacteria

Characters Vibrio Campylobacter Pseudomonas Enterobacteriaceae H. pylori

Curved rod + + - -

Oxidase + + + -

Motility + + + +/-

Flagella locations Polar Polar Polar Peritrichous

Growth charac- Facultative Micro- Strickly Facultative teristic anaerobe aerophile aerobe anaerobe

63

Obligate

aerobes

Obligate anaerobes

Facultative anaerobes

Microaerophiles

Aero-

tolerance

Bacteria

Brooks GF et al. Jawetz, Melnick & Adelbergs Medical Microbiology. 25th ed.

New York : McGrawhill, 2010.

Murray PR, Rosenthal KS, and Pfaller MA. Medical Microbiology. 6th ed.

St.Louis : Mosby/Elsevier, 2009.

Bacteriology 9 Enterobacteriaceae

Bacteriology 10 Vibrionaceae and Nonfermenters

64

241 entero 18 jan 2012

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